The purpose in writing this article is to educate those men who recently were diagnosed with prostate cancer and those who will be in the future.
Prostate cancer is diagnosed in approximately 250,000 men each year. It is one of the most treatable types of cancer and causes only 40,000 deaths a year, which is less than 2% of the men affected. Medical literature suggests that more than 60% of men over the age of 80 will develop cancerous prostate cells. It is interesting, and somewhat disturbing, that different urologists recommend very different treatments for their patients.
I have seen three urologists over the past several years. The first performed a biopsy of my prostate when my PSA level elevated past 5.0, which is about the level that causes doctors to start searching for a cause. The biopsy showed cancer in one of the 12 samples taken, but my doctor said that was not severe and rather normal for someone my age. A few years later, my primary physician was startled to see my PSA level go above 15.0 and recommended that I see a different urologist, which I did. He tested my prostate and said it was larger than normal but saw no reason to perform a biopsy. When my PSA level surpassed 30.0, my primary physician said we needed to find a different urologist. When I saw my new doctor, he was alarmed, ordered a biopsy, and again discovered one cancerous sample out of 12 taken. He immediately prescribed a blood test at a special laboratory to confirm the finding, which it did. He also prescribed a scan of my prostate to confirm the size of the cancerous area and a full body scan to make sure the cancer had not spread to other organs in my body. He also prescribed that I take Bicalutamide daily to shrink the prostate and gave me an injection of Eligard to stop the cancerous growth. He said there were various ways to treat the cancer: do nothing, which was not realistic; have surgery, which would not be available to me because of my age; or start radical or less radical radiation treatments to eradicate the cancer. The latter course of action was decided upon and he then introduced me to a doctor who has a radiation facility and he scheduled me for 40 radiation treatments over an 8-week period.
A friend of mine in the western U.S. decided upon the radical course of action and underwent both radiation treatments and massive injections to kill the cancer. Interestingly, he laid on his stomach for his treatments while I laid on my back. His injections were given at a hospital and were extreme to the point where his body had to be numbed to enable him to endure the injections. My injections were limited to one before the radiation treatments and one following the conclusion of the treatments.
Another friend who was recently diagnosed with prostate cancer had a much different recommendation by his doctor. After the diagnosis was confirmed by a biopsy and a blood test, his doctor recommended that he wait a month or so and then have a second biopsy to determine what the cancer was doing. No Bicalutamide to shrink the gland nor an injection of Eligard to stop the growth. I was shocked by that course of action, but I am no expert in this area and this doctor must have had reasons for the direction he recommended.
And yet another friend confided in me at a business lunch that he was just diagnosed with prostate cancer and, when I shared my experience, with him he was genuinely appreciative and somewhat relieved.
The side effects I encountered during the two-month treatments, which were performed daily except for weekends and holidays, were considerable fatigue after the halfway point and an occasional burning sensation in the treatment area.
Friends who are about to undertake a similar treatment schedule often ask if there is any pain or discomfort associated with it. There was absolutely no pain or even discomfort caused by the daily treatments. There was some discomfort during the different biopsies, but not really pain. The only procedure that produced either strong discomfort or mild pain was when the gold “markers” were inserted to give the radiation equipment a target to focus in on to make sure the radiation would not miss the tiny cancerous area and when the doctor inserted Hydrogel to separate my prostate from other organs which might otherwise get damaged by the radiation. It is a fairly new product which my wife heard advertised on television. The process for inserting the gel is similar to having a biopsy and, because it is new, two or three pharmaceutical representatives plus the doctor and one or two assistants joined in the occasion to witness this man with his feet in stirrups undergoing the insertion procedure. I was only able to refrain from commenting on the discomfort I was experiencing by imagining what the head rep would tell his friends when asked what he did for a living. Of course, his response would be that he worked with a bunch of a–holes every day. That humor, if that’s what it was, helped me survive the procedure with relative ease.
A few days after my treatments came to an end, I had one more injection of Eligard. I assume there will be one or more CT Scans and biopsies down the road, but it will be worth knowing that the cancer has not returned and is in the past. At present, my PSA level is “0.”
If you are facing a similar course of treatment, I hope this information will allow you to proceed with some knowledge of what to expect and that at least one person sailed through with very little to complain about. To the contrary, my doctors and the facility itself were kind, professional, efficient and always available to field questions.